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How to quit smoking

Dr Roger Henderson
Reviewed by Roger HendersonReviewed on 29.04.2024 | 8 minutes read

While most of us know that there are no benefits to smoking, it can be difficult to stop. Some people think stopping is all about willpower, and they insist on going cold turkey to give up – but experience tells us that they are more likely to return to smoking in future, and only 3 in 100 of smokers who try to quit in this way actually succeed.

The good news is that there are several tried and tested methods that will help you quit smoking, but it’s always worth taking the time to understand the hold cigarettes have on us first.

Why is it so hard to quit smoking?

Smoking tobacco is highly addictive due to the nicotine element that it contains. Nicotine affects the brain in a way that releases endorphins in the brain. These are ‘feel good’ chemicals that make us feel happy and are highly addictive, creating cravings for them once their nicotine trigger has stopped.

This temporary high is a hefty price to pay for the cost of smoking to the body. In the UK, almost 100,000 people die from smoking-related diseases every year, and there are over half a million hospital admissions due to smoking annually.

Smoking takes a mental hold on us, providing a psychological crutch that’s hard to give up. Daily smoking can become a habit – a ritual around drinking, morning coffee, work breaks and nights out. It can take at least 60 days to break such a habit, which is why relapses occur so often for those trying to quit smoking.

To quit for good, smokers must adjust their lifestyle completely, ensuring that it is no longer a part of their routine and daily activities, and is not used to comfort low mood, anxiety, depression or boredom.

So, let’s talk through how to quit smoking, including some tried and tested methods to put you in the best position to quit and stay that way.

Doctor’s advice

Preparing yourself to quit

The first place to start when quitting smoking is to identify why you smoke. For most people, it is because of the addictive nicotine effects, but habits are complex behaviours that re-enforce the addiction to smoking, such as:

  • smoking being a part of your lifestyle
  • smoking being habitual
  • smoking to cope with stress
  • smoking to cope with low moods
  • smoking to cope with boredom
  • smoking as a social activity – with friends, family or work colleagues

It is important to identify which of these areas applies to you. This will help you identify the first steps you need to take to quit smoking. Only then can you go on to take full advantage of services and aids that can help you.

NHS Stop Smoking service

For most of those who successfully quit smoking, the free NHS Stop Smoking service offers you the best chance to quit. An expert adviser will encourage you to pick the best date to stop and help you mentally prepare. Your GP can also help with this if you do not have this service available to you in your area. They may encourage you to look at reasons you wish to give up smoking, barriers to stopping, and reasons that keep you smoking. They may ask about previous attempts to quit and will then champion you all the way along your journey to quitting.

Breaking the behavioural habit is much harder than the chemical addiction – you may associate cigarettes with a break from work, a reward, stress relief, or a night out with friends. They need to be addressed rather than ignored, and strategies put in place – such as avoiding some social situations at the beginning – rather than hoping for the best.

Your doctor can put you in touch with your local Stop Smoking service, or your hospital, if you are receiving treatment there. Other options include apps, helplines and text messaging services – ask your doctor what’s available in your area.

Coping with nicotine withdrawal symptoms

One thing people overlook when trying to quit is how to quit smoking and cope with the withdrawal symptoms that always accompany it. This can make or break the quitting process and is ultimately why it becomes a challenge.

The body does fight this process, so symptoms can range from simple cravings to physical pain. Every person varies in how intense these cravings are and how long they last, but for most, symptoms start around an hour after the last cigarette and peak around 48 hours later. These can continue for up to four weeks.

Nicotine withdrawal symptoms include:

  • cigarette cravings
  • irritability, frustration, or anger
  • anxiety or nervousness
  • difficulty concentrating
  • restlessness
  • increased appetite
  • headaches and migraines
  • insomnia
  • tremors
  • increased coughing
  • fatigue
  • constipation or upset stomach
  • depression
  • decreased heart rate

These symptoms usually ease off as the toxins are flushed from the body, so it only works if the quitter is persistent. It’s a good idea to make your colleagues, family and friends aware you may experience these symptoms, so they can be more understanding and supportive throughout this challenging time.

Treatment: products

Nicotine replacement therapy and anti-craving medication

Nicotine is the addictive substance in cigarettes. Withdrawal of nicotine is what sparks the craving to smoke, and this peaks after about three days and continues for about two weeks.

Nicotine replacement therapy (NRT) is a highly effective way to reduce these cravings, and you will be prescribed a reducing regimen to ease you off the chemical addiction. These come as gum, lozenges, patches, sprays or tablets. It is now recommended that ‘combination’ or double NRT is always used, as this increases the chances of quitting successfully. In practice this means using a patch NRT to give slow-release cover with quick-release products such as sprays to help deal with any breakthrough cravings that may occur.

Zyban and Varenicline are tablets prescribed to reduce cravings and withdrawal symptoms and reduce the pleasurable effects of smoking and nicotine. These are available on prescription.

If NRT is not for you, there are alternatives to managing nicotine withdrawal without using a chemical replacement. These include some old-fashioned psychological tricks to overcome temptation. Alternative ways to manage nicotine cravings include:

  • distract yourself
  • remind yourself why you quit
  • get out of the tempting situation
  • reward yourself in other ways

Vaping and e-cigarettes

Electronic cigarettes or vapes have become popular in recent years with almost 4 million users now in the UK, and offer two ways to help stop smoking: they give you something to hold and draw on, imitating a cigarette, and they can provide nicotine as an alternative means of replacement.

This makes vaping an alternative that addresses both the habitual and chemical causes of smoking.

Unfortunately, these are not available on the NHS as it is too early yet to know any long-term risks but the UK medical authorities consider them considerably better for your health than cigarettes, so this may be an attractive option for you. Bear in mind though that you should always ultimately aim to quit vaping at some point, too.

Treatment: home & drug-free

For many people, smoking has become integrated into their everyday lifestyle. It can be a strong habit to break but don’t lose heart, there are ways to adjust your lifestyle to welcome in new healthy habits.

Here are some lifestyle changes that can help:

Regular Exercise: Some people find taking up exercise helps when quitting smoking – they can monitor an increase in fitness and wellbeing from the date they quit, and it helps release endorphins and clear any stress that can build up with quitting smoking.

Start new hobbies and projects: Distraction techniques can be a useful tool to help quit – immersing yourself in a hobby or starting a new project, or simply setting aside time for reading, cooking or listening to music at the times you would have had a cigarette. This helps you create new habits that you don’t associate with smoking.

Set a quit date goal: Setting your quit date is important – you can discuss this with your adviser, but why not plan something fun to look forward to then? Or take time away or on holiday to remove yourself from any initial temptations to smoke. Make sure you remove all smoking paraphernalia and everything that reminds you of smoking before quitting.

Use your friends and family for support: Let your family and friends know, so they can support you. If they smoke, you could even quit together to boost your chances. It is much easier to quit when you have declared your intention and set expectations among your family and friends.

Focus on the benefits and treat yourself: You’ll notice several benefits to quitting smoking. From financial benefits to health improvements. Take note of these and keep reminding yourself why you are quitting smoking. Keep tabs on the money you’re saving from kicking the habit – perhaps save up for something nice to reward all your hard work.

What if you slip up?

Quitting is not an easy task. It’s common to take multiple attempts when fighting nicotine addiction, so slips and relapses do happen, and it’s not something to beat yourself up about. In any situation where setbacks occur, try to view it as a learning opportunity rather than a total failure. Use the relapse to analyse why this occurred and what triggers caused it. From there, implement changes to your plan and avoid any traps in future. And you can always try again.

If quitting is proving difficult, talk to a doctor about medical aids and confide in family and friends to keep your morale boosted throughout the process.

What happens to your body once you quit smoking?

A final positive note, if you need any more incentive: you are looking at a healthier you if you quit and stay quit. Your body will feel better within hours of stopping, with short-term effects like your heart rate and oxygen levels returning to normal, and carbon monoxide and other poisonous chemicals will be flushed out of the body.

It can take time for your lungs to work through damage and repair the lung tissue, but lung function can improve by around 10% within nine months. The same goes for the heart, taking around a year for healthy circulation to return.

Looking to the future, you will halve your chance of lung cancer within 10 years, compared to someone else who has continued to smoke.

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Dr Roger Henderson
Reviewed by Roger Henderson
Reviewed on 29.04.2024
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